Urinary incontinence is a troubling yet common effect of radical prostatectomy, affecting 4% to 87% of patients. The impact of urinary incontinence can reach far beyond the physical discomforts of skin irritation, physical activity restrictions, and adverse drug events: The economic impact caused by the purchasing of management supplies, diagnostic and treatment procedures, and long-term care add to the psychological concerns centered around embarrassment, guilt, and frustration.
John P. Lavelle, MBCHB, notes that too many patients adhere to “avoidance therapy,” pleased that they no longer have prostate cancer but trying their best to manage the urinary leakage on their own by wearing an absorbent pad and hiding from society. Regrettably, physicians also tend to practice avoidance therapy. “A lot of people don’t want to talk about [incontinence], but I think it’s important to bring the thing up correctly to the patient,” instructed Dr. Lavelle. “Assume that they have it, and if they tell you that they don’t, that’s great.”
